Clinical evidence

Evidence Search

You are here

LMA Supreme™ – a new single-use LMA™ with gastric access: a report on its clinical efficacy

LMA Supreme™ – a new single-use LMA™ with gastric access: a report on its clinical efficacy

Authors

Verghese C., Ramaswamy B.

Publication

Br J Anaesth 2008; 101 (3): 405-410.

Summary

A study to compare the clinical efficacy of the LMA Supreme™ and the LMA ProSeal™ in female patients undergoing surgery requiring general anaesthesia with neuromuscular block and positive pressure ventilation

Insertion of the LMA Supreme™ was successful on the first attempt in the overwhelming majority of patients

The LMA Supreme™ was easy and quick to insert and had a glottic seal pressure that was similar to the LMA ProSeal™

Objectives:

To compare the clinical efficacy of the LMA Supreme™ and the LMA ProSeal™ in female patients undergoing surgery requiring general anaesthesia with neuromuscular block and positive pressure ventilation

Method:

This was a randomised, crossover study

Eligible patients were required to be American Society of Anesthesiologists class 1-3 and be in a fasted state

Patients had both the LMA Supreme™ and the LMA ProSeal™ devices inserted during the course of the study

Patients were initially randomised to receive either the LMA Supreme™ or the LMA ProSeal™ device

After relevant measurements had been secured, the comparator device was inserted and remained in situ until the end of the surgical procedure

The endpoints of the study were

Ease of insertion and number of insertion attempts

Volume of air required to maintain a cuff pressure of 60 cm H2O

Glottic seal pressure

Passage of a gastric tube

View of the glottis (determined using fibreoptic laryngoscopy)

Results:

Overall, 36 patients with a mean age and body mass index of 48.8-51.1 years and 29.2-30.3 kg/m2, respectively, were included in the study

The LMA Supreme™ and LMA ProSeal™ devices were successfully inserted in all patients

Insertion of the LMA Supreme™ and the LMA ProSeal™ was successful on the first attempt in 35 of 36 patients

Three insertion attempts with the LMA Supreme™ were required in one patient (likely because the device was too big for the patient)

Insertion of the LMA Supreme™ was successful on the first attempt in the overwhelming majority of patients

The volume of air required to maintain a cuff pressure of 60 cm H2O was similar in patients who received the LMA Supreme™ and the LMA ProSeal™ in the first period (mean 21.9 vs. 22.4 ml; p=0.78)

The use of both devices resulted in a similar fibreoptic laryngoscopy score

Scores of 1 (full view of the arytenoids and glottis) to 2 (arytenoids and glottis partly visible) were recorded in 29 of 36 patients treated with the LMA Supreme™ and the LMA ProSeal™

A gastric tube was successfully passed through the drain tube into the stomach on the first attempt in all patients

The median volume of gastric aspirate with the LMA Supreme™ and the LMA ProSeal™ was 17.5 and 15 ml, respectively, while the median pH was 1.5 and 3, respectively

Conclusions:

The LMA Supreme™ is easy and quick to insert, has a glottic seal pressure similar to the LMA ProSeal™ and allows easy access to liquid gastric contents

Teleflex, the Teleflex logo, MAD, MADdy, MADgic, MADgic Airway, MAD Nasal and MADomizer are trademarks or registered trademarks of Teleflex Incorporated or its affiliates in the US and/or other countries.